Cheshire East Accom. Support Referral System

Cheshire Accommodation Support Service for over 16’s.
Welcome to our online referral portal. If you need support with your referral, or have any questions, please call our 24/7 service on 01625 669629 or email cheshire@p3charity.org

Which Service are you making a referral to?

Who are you making a referral for?

We don’t need to know your National Insurance number right now, only whether you will be able to provide it before accomodation is offered.

Please confirm you have the appropriate authority and consent to share the persons details with us for the purposes of providing them a support service. You must have this before you continue.

To confirm, please click the below button.

Do you know yourtheir National Insurance Number

You can continue with your referral, but please note a National Insurance number will need to be provided at a later date before we are able to offer accommodation.

If you have previously received support from us, we can review previous records (only with your consent) to ensure we can pick-up from previous support provided.

Have youthey ever been referred to P3 service before

Please select the option that applies:

We use this information to help make sure any support we can offer meets your needs.

Do you Does the individual have previous experience of being in Care?

Do you have a social worker or Personal Advisor (PA)?

Please select all options that apply to yourtheir circumstances.

We use this information to help make sure any support we can offer meets your needs, and to check our supported accommodation is the right fit for your circumstances. We also use this information to help in identifying any urgent needs you may have so that we are able to respond as quickly as possible to your referral on our waiting list.

We use your name in order to address you when responding to or contacting you about your referral.

We use your relationship to the individual information to monitor the sources of our referrals and to ensure we are aware of you as a key contact for the individual being referred.

We use organisation information to monitor the sources of our referrals and to help us contact you if we need to.

We use contact information to keep you informed about your referral, and/or to contact you to clarify or discuss any information you may have provided.

We use risk information to ensure our staff are fully aware of any circumstances that may require us to take appropriate steps to ensure the safety of the individual being referred, others residing in our accommodation and our P3 teams.

Referrer Details

Risks:

 

We use your name in order to address you when discussing your referral and any future correspondence or communication in relation to your support

We use date of birth information to make sure the services we offer are able to meet your needs.

We use contact information to get in touch about your referral. By adding your contact details, you consent to us using them for the purposes of following up on your referral and/or providing you with accommodation and support.

We’ll do our best to make sure we contact you using the most convenient method and at the most convenient time

If you’re happy for us to leave a voicemail on the numbers you have provided, please provide your consent. If you don’t, we’ll still call you – but we won’t leave a voicemail.

YourTheir Details

The gender youthey identify as:

Your chosen pronouns:

YourTheir date of birth

Please enter in the boxes below

YourTheir Contact Details

What is yourtheir best contact? Please provide one or more of the requested contact details:

Which is yourtheir preferred contact method?

Contact Time – when is the best time to contact youthem?

Are you happy for us to leave a voicemail?

We use your address in case we may need to send any letters/information to you or visit for something related to your support if needed.

YourTheir Current or Last Know Address

If anyone else lives at this address, please provide some information. (i.e. Partner, Children).

We use language preference information to ensure we communicate with you in the best way for you. We use communication needs information to ensure we can adapt our service, support, and contact arrangements to fit any accessibility requirements you may have

Preferred Language

Do theyyou have any communication needs?

Do theyyou have any allergies? Please mark any that apply.

We use this information to allow us to understand what it is you may feel you need help with, and to help us with identifying any urgent needs you may have so that we are able to respond as quickly as possible to your referral on our waiting list.

Their CircumstancesYour circumstances

Please select any other circumstances that currently apply

We use this information to allow us to understand the reasons behind the need for support from our service.

Please let us know here what you feel are the main reason(s) you would like support and accommodation from P3.

We use this information to allow us to plan future support requirements and ensure you are receiving all of the support you are entitled to based on your circumstances.

TheirYour current income support

– please select which types of income currently apply

We use the emergency contact information as part of our safeguarding procedures, for example, if we have concerns for yours or others safety/welfare or in the event of an emergency we may be required to reach out to your chosen emergency contact. We use the (optional) information about other people or organisations you’ve told us about here to make sure we work together with them where possible for your support

Others involved

Please enter one or more contact numbers for the emergency contact

Availability

Availability

Availability

Are there any other organisations or professionals involved in supporting the personyou?

Data Consent

Please read and accept your understanding of our Privacy Statement which can be found here.

Feedback

Please rate your experience of this referral process

To what extent do you feel that this referral portal was easy to use?

Do you have any further comments or suggestions about our referral process?

 

Colour Scheme: